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      How to get your questions answered. A few observations, and requests of all members. All folks who come here are volunteers who do this on their own time and their own dime.To avoid burning out our best contributors please follow these guidelinesf you are reading a post and it reminds you of a question you want to ask, start a new topic, if you place your question in someone thread it will be difficult to distinguish your question from the original poster, you will get better results posting a new topic with your question. 1. Before Posting please do a search and see if your question has already been answered. If you find the answer print it out and put it in a file to use as a reference file, I find this helpful myself. 2. If you can not find the answer and you do post a question, please print out those answers and refer to them to avoid duplicate questions. 3. Refer to the Frequently Asked Questions4. Duplicate questions will come up from time to time but the keeping them to the minimum will lighten the load on the regular volunteers.5. Respect folks privacy do not request their personal phone numbers for claims help, it is inappropriate and not why they are here.6. Keep the topics focused on veterans issues, in closing Search first Search ... Ask second.it may save a lot of time or at the very least enlighten you.
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    • A bit about Tbird and HadIt.com for those who've asked...

      The following is on my About page, but some have been asking how this all happened. So here is my little story. Tbird US Navy 1983 – 1990 E-6 HadIt.com the website domain registered Jan 20, 1997 the domain is registered and paid for through Jan 21, 2023 at which time I plan to register it for another 15 years Lord willing and the creek don't rise. I guess the best place to start is Jan 1991; I had gotten out of the navy Dec 1990. At my separation seminar, there was a DAV rep Jim Milton he told us to bring our medical records in and he would look through them for us and let us know if we should file a claim with the VA. Well, bless his heart, he opened my medical file, reads the first insert, looks me straight in the eye, and says you will be 50% for the rest of your life and he would file the claim for me. 50% was for surgery I had in the service. True to his word he met with me and talked with me for a long time filled out my paper work and urged me to file for PTSD. I would not file the PTSD claim, nor even discuss it. By Feb 1991 I had moved to the San Francisco bay area and was staying at a friends apartment and pretty much I was just a puddle. In desperation one night I called suicide hot line, I had no job, no idea about going to the VA. They talked with me for a long time and explained to me that I could go to the local VA hospital even if I did not have insurance. Now, I know what you are thinking if I was 50% why didn't I just go to the VA in the first place, two reasons 1, this was Feb 1991 and the 50% didn't come till May and 2, even if it had come through it is unlikely that I would have had the mental acuity at the time to put the two together. I relate this here because it is where so many of our brothers and sisters are coming from, perhaps where you started. Fuzzy and unsure, in pain and sometimes homeless they come to the VA hospital for help. And that is where I ended up. Up to the pysch ward I went, blah, blah, blah, a few days later I was released with a promise of a call from the out patient program, which I would soon be entering. Blah, blah, blah, after many missed communications, and no call backs I was at the Day Hospital everyday M-F. And this brothers and sisters is where I began to learn and formulate my plan for HadIt.com. Veterans, veterans everywhere…I spent a year in the day hospital and about another year at a sheltered workshop before I got back on my feet. So I just talked to veterans everyday waiting for appointments, waiting for prescriptions, waiting for a vet rep and I started to learn the system. While in the navy I was data analyst and had to learn a 5 volume manual and just about anything you were suppose to do was in that manual. So I figured there must be a manual on how to do a VA claim or at the very least regulations. So I found out about the Code of Federal Regulations, United States Code, Veterans Affairs Manuals and so on and so forth. Of course this was 1991/1992 I was living in a tiny studio apartment in a particularly bad neighborhood, working in a sheltered workshop making a nickel per envelope I stuffed throw in PTSD and you will see that it was a difficult task for me to get somewhere where they had copies of these, let alone that they would let me look at. And there was so much knowledge around me, it was like the gold rush in those days, I could just sit on a bench a veteran would sit down next to me a little conversation later I had another nugget, I made copious notes. Phone numbers to call, ask for this guy or that guy he'll give you the straight scoop and they'd slip me a piece of paper with a number on it. You want to read this regulation or that one and another slip of paper into my hand. I spent a lot of time on those benches watching the squirrels they gathered their nuts and I gathered mine :) So I'm thinking I could put a little handbook together print it out and hand it out at the VA. Or perhaps fliers. Still formulating, time goes by, 1994/1995 I am being treated for PTSD regularly and doing and feeling much better and I go to work for a company as a marketing systems analyst and I discover the internet. Well let me tell you that was perhaps one of the most significant life changing events I have ever experienced. And I might add finally a positive one :) It seemed only natural to me that surely there must be a website that contained all the knowledge I wanted, well as it turned out not so much, lots of stuff but I wanted to get straight to the claims information and there was a lot of stuff to wade through to get to it. So taking my lesson from the squirrels earlier I started to gather, gather, gather…and learn HTML and work as a marketing systems analyst and work my claim. 1996/1997 major PTSD cork blows and unemployed. Working my claim, working the website. 20 Jan 1997 register HadIt.com domain name right after getting off the phone with the VA and saying I've had it with this. As fate would have it the old DAV board goes down just as mine opens up and folks start to wander in. So HadIt.com has two main components the website which supports the discussion board with links, articles, research resources etc. The website starts to grow, I can't tell you how many times I had to switch servers for space and features. I continue on a downward trend and in 1998 ended up back home in St Louis living in my sisters basement in therapy and working it, I swear I would have swung a dead chicken around my head at midnight naked if I thought it would have helped. The website continued to do great during this time, I just stayed in the basement bought new software, new books, and learned how to make things work and I continued to use this knowledge to make HadIt.com better. My 100% finally came through from the VA and I had a friend who is an advocate who helped me thru my SSDI claim, he was literally at my side thru the entire process and that came through for me. My therapist and sister continued to try and get me to leave the basement, but to no avail. At some point in 1998 or 1999 I put a counter on the website and was shocked to discover how many visitors we were getting. Time goes by my sister gets married and I move from the basement to the upstairs, there is much celebration that Aunt T is living in the light again. More time goes by and I settle into my life in St Louis and spend more time on the site trying new things, finding more information. 2003 I buy my own home VA loan. For years now I have just considered HadIt.com my job and I get up every morning go to the office and work for several hours, take an afternoon break and see where the rest of day takes me. I have a place in the office to use the computer and a comfortable to place to read journals and articles and take notes. Blah, blah, blah so that is my story and HadIt.com's intertwined.
    • HadIt.com Pass It On Cards

      Hi I've updated our HadIt.com Pass It On Cards. They are in a PDF format you can print them out cut them there are 12 to a page. If you have found HadIt.com helpful and would like to pass it on to other veterans this is an easy way to do it.I hope you find them helpful, feel free to leave a few anywhere veterans gather, veterans centers, veterans hospitals, public libraries, be creative. Please make sure though, that if you want to leave some at any business you ask permission first.Here you go http://www.hadit.com...it_on_cards.pdf
    • VA Training and Fast Letter Forum Index

      VA Training and Fast Letter Forum Index The following is the index with links to the various Training and Fast Letters plus a few miscellaneous. These letters are not necessarily in the original formatting. I have tried to present them in an easy-to-read form instead of some forms as originally presented. Some of the paragraphs were WAAAAYYY too long. lol - HadIt.com Member fanaticbooks Something to be aware.... Some of these letters may be rescinded, outdated, or otherwise no longer viable. I have still included them because sometimes they provide additional insight or just plain more information than the newest version. Use them wisely. The oldest letters will display at the bottom with the latest letters displayed at the top, all in sequential numbers. Coding of the letters... FL = Fast Letter TL = Training Letter First two numbers = last two digits of year of origin Training Letter http://www.hadit.com/forums/index.php?/topic/40694-va-tl-00-07/ http://www.hadit.com/forums/index.php?/topic/40693-va-tl-00-06/ Fast Letter Number Title http://www.hadit.com/forums/index.php?/topic/44262-va-fl-11-15/ http://www.hadit.com/forums/index.php?/topic/44260-va-fl-11-13/ http://www.hadit.com/forums/index.php?/topic/44261-va-fl-11-11/ http://www.hadit.com/forums/index.php?/topic/44310-va-fl-11-09/ http://www.hadit.com/forums/index.php?/topic/42151-va-fl-11-03/ http://www.hadit.com/forums/index.php?/topic/40957-va-fl-10-49/ http://www.hadit.com/forums/index.php?/topic/40958-va-fl-10-46/ http://www.hadit.com/forums/index.php?/topic/40959-va-fl-10-45/ http://www.hadit.com/forums/index.php?/topic/40960-va-fl-10-42/ http://www.hadit.com/forums/index.php?/topic/40961-va-fl-10-39/ http://www.hadit.com/forums/index.php?/topic/40962-va-fl-10-35/ 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  • 0

C&p Reduction?

Question

Posted

Just had my C&P reduced from 40% to 20% stating my sight got better. Have had surgery on this SC issue twice. I was totally stunned by this result. I entered the Navy in 72 with perfect sight then upon discharge had change in vision along with pterygium in one eye. Noted in records as SC but no compensation awarded when discharged as it stated it was not warranted. Now, fast forward to 85 had surgery on right eye to remove pterygium and now have another growing in left eye. Now to 2004 had surgery on left eye for pterygium that was causing problems with cornea nothing more can be done to right eye as the astigmatism, cornea scarring cannot be fixed. Now 2005 found old service records stating my SC so I filed then for C&P and was awarded 10%, then re-applied in 2007 for increase they found previous ruling was a CUE awarded 40%. Now applied for increase in 2010 nothing given as things were slightly better. Now 2012 I applied yet again for increase and they reduced my award from 40% to 20% stating vision is better. How can they reduce it? Vision is still bad cannot read small print have to have wife or someone else read for me. Cannot drive at night since I cannot see the signs or markings on the road. I can drive during the day if the weather is good. If it rains my vision is extremely impaired. The cornea is wrinkled on both eyes and astigmatism is on both eyes now as well. Only have 60 days for rebuttal and I am extremely upset at this development. Eyes are not gonna get better unless I have a transplant and there is no guarantee that it will take and with diabetes it is even more risky. Diabetes SC has been denied with the "Boots on the ground" issue even though I was in the gulf of tonkin. Hearing is also, SC but not severe enough yet to get compensation. What is the best way to fight this...if attorney is needed any suggestions on who to get in Calif.

Thanks

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8 answers to this question

Posted

I replied to this in the Lawyers topic here:

Diabetes SC has been denied with the "Boots on the ground" issue even though I was in the gulf of tonkin. "

Have you checked the most recent AO ship's list from VA?

http://www.publichea...iplist/list.asp

Also, when Navy Times posted this info, a commenter in this link mentioned many carriers were in the Tonkin for many months,during the war.

http://www.navytimes...-guard-012112w/

You might need to consider getting an IMO from an eye specialist.

Are you able to scan and attach here, their Reasons and Bases for their decision? (Cover all identifying info)

An attorney ,if retained, might sure ask for the same thing,- an independent medical evaluation of your current condition.

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Posted

Have you filed for any official Notice of Disagreement on all these times they were messing with your rating? And yes, on the issue of disputing the lowering of your rating, I would not hire a lawyer. Unless you really need to.

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Posted

As I read your post, the examination associated with your 2010 claim for increase showed improvement (in your visual acuity?) thus no increase was granted. You then filed another request for increase in 2012 and the associated C&PE showed improvement (in your visual acuity?).

To answer your specific question though, How can they reduce it? .. yes they can propose to reduce the evaluation because you have had two examinations which do not show that a 40% (for decreased visual acuity?) due to pterygium is warranted. The rating criteria for pterygium based on visual acuity are at 38 CFR 4.79 http://www.benefits....PART4/S4_79.DOC using the analogous Diagnostic Code 6034-606x.

Some questions and thoughts:

a. This is the problem with requesting an increase - sometimes you don't get the increase and moreover you can put yourself in a position for a reduction.

b. As for difficulty reading, night driving, and so forth, they really aren't considered per the Rating Schedule.

c. What are your uncorrected visual acuities for each eye? This is to see if 38 CFR 3.383(a)(1) http://www.benefits....3/S3_383.Paired Organs http://www.benefits....ART3/S3_383.DOC is an issue.

d. I am presuming that you are service connected for pterygium of the right eye/cornea and that the left eye/cornea pterygium is not service connected ... is that correct? What are your corrected visual acuities for each eye?

e. Per 38 CFR 4.75(b) http://www.benefits.va.gov/warms/docs/regs/38CFR/BOOKC/PART4/S4_75.DOC , eye examinations are done by an optometrist or ophthalmologist. So, I'm pretty sure that you already have had specialist examinations.

f. Actually, I don't believe that you can file a Notice of Disagreement (NOD) at this time because an adverse action has not been taken, it has only been proposed.

g. The only way, at this moment, to stop the proposed reduction is to provide another examination that show different visual acuities. You might be able to get this done at your VAMC, but you might have to spring for it yourself with a civilian provider. Note: another exam may show essentially the same or perhaps even better acuities.

h. If the reduction does takes place, you can then file a NOD and ask for a Decision Review Officer (DRO) de Novo review. The DRO may - or may not - request another optometry/ophthalmology examination.

Just had my C&P reduced from 40% to 20% stating my sight got better. Have had surgery on this SC issue twice. I was totally stunned by this result. I entered the Navy in 72 with perfect sight then upon discharge had change in vision along with pterygium in one eye. Noted in records as SC but no compensation awarded when discharged as it stated it was not warranted. Now, fast forward to 85 had surgery on right eye to remove pterygium and now have another growing in left eye. Now to 2004 had surgery on left eye for pterygium that was causing problems with cornea nothing more can be done to right eye as the astigmatism, cornea scarring cannot be fixed. Now 2005 found old service records stating my SC so I filed then for C&P and was awarded 10%, then re-applied in 2007 for increase they found previous ruling was a CUE awarded 40%. Now applied for increase in 2010 nothing given as things were slightly better. Now 2012 I applied yet again for increase and they reduced my award from 40% to 20% stating vision is better. How can they reduce it? Vision is still bad cannot read small print have to have wife or someone else read for me. Cannot drive at night since I cannot see the signs or markings on the road. I can drive during the day if the weather is good. If it rains my vision is extremely impaired. The cornea is wrinkled on both eyes and astigmatism is on both eyes now as well. Only have 60 days for rebuttal and I am extremely upset at this development. Eyes are not gonna get better unless I have a transplant and there is no guarantee that it will take and with diabetes it is even more risky. Diabetes SC has been denied with the "Boots on the ground" issue even though I was in the gulf of tonkin. Hearing is also, SC but not severe enough yet to get compensation. What is the best way to fight this...if attorney is needed any suggestions on who to get in Calif.

Thanks

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Posted

I had a pterygium in my eye. The doctor told me that if it drifts toward the cornea I would have it removed or I would be in trouble with Vision problems. It moved toward the cornea almost touching it and then I had it removed.

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Posted

SC was for both eyes at time of discharge but only had treatment in service for one eye but was noted that both eyes were a problem ie blurry vision, redness and unable to read for long periods.

Due to the surgery on the right eye twice the scarring has caused "astigmatism" eye looks like the shape of a football when photos were taken. This eye is basically going to be gone due to the astigmatism and pterygium which cannot be removed at this point as it is on the cornea.

Eye exam in 2010 notes: Pterygium BE, s/p pterygium surgery with iron line deposit, corneal scarring & irregular astigmatism RE > LE, s/p PTK RE for stromal scar.

Further states in "Assessment"

1. refractive error/presbyopia

2. diabetes with no retinopathy BE

3. choroidal nevi LE

4. mild cataracts BE

5. pterygium BE, s/p surgical removal with persistent corneal scarring and irregular astigmatism, h/o inability to adapt to contact lens wear

Slit lamp & external eye exam cornea: marked other, describe: pterygium RE, surface irregularity LE. Lens: describe: ant cortical opacities BE

C&P exam 2012 under "Corneal conditions" Does the veteran have another corneal condition that may result in an irregular cornea? (Fore example, pellucid marginal degeneration, irregular astigmatism from corneal scar, post-laser refractive surgery, acne rosacea keratopathy, etc.) Dr. says "NO". Previous notes from 2010 exam states other wise.

Next page of questions in C&P under cataract condition: "Preoperative (cataract is present) which is marked for BE then, it says : Is the Veteran's decrease in visual acuity or other visual impairment, if present, attributable to any of the eye conditions checked above in this section he says no. If no, explain: decrease due to high astigmatism. (I understand this to mean Cataract condition does not cause astigmatism).

Next page under "Functional impact" ... impact his/her ability to work? Dr. marked "YES" If yes, describe impact: "HIs borderline vision would limit him for many occupations".

Remarks if any: Cataracts are likely due to diabetes which has a high prevalence of cataracts.

Visual acuity: 20/200 RE, 20/100 LE (UC distance), UC near 5/200 RE, 5/200 LE, CD 20/50 RE, 20/40 LE, CN 20/100 RE, 20/70 LE.

Since, the reduction is being reviewed does this mean that the CUE "they found" before is now reversed and their own findings were wrong when they said it was a CUE???

As for the "Boots on the Ground" ship is not listed as of yet. I have been put on the AO list, had the exam etc but nothing more. When I went to file for this lastest C&P exam VA rep told me that my claim for AO exposure was denied before and it was a "dead issue". I can remember being able to see soldiers on the shore firing at our ship so we had to have been pretty close.

Going for a IMO in two weeks.

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“Since, the reduction is being reviewed does this mean that the CUE "they found" before is now reversed and their own findings were wrong when they said it was a CUE??? “

I dont understand what you mean there-

a “proposed reduction” means just that- they intend to reduce your comp or already did.

Have you asked for a Hearing yet on this?

You could submit the IMO you get (if it is favorable and follows the IMO criteria here) hopefully within the 60 day deadline, and if not a hearing request made ASAP within the deadline would offer you an opportunity to submit the IMO then.

Sooner is far better then later in cases of a proposed reduction.

I handled one regarding my husband many years ago. They dropped the reduction idea when they got the NOD.

He didn't need an IMO and never requested a VA hearing because the VA's medical rationale in the reduction letter was absurd and also VA did not consider the appropriate regulations properly.

But your type of claim needs a strong IMO ,in my opinion.

If it doesn't follow the IMO criteria here in the IMO forum and the terminology as to “as likely as not” etc with a full medical rationale, the VA will give it no weight to combat the C & P exam results.

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Most eye conditions (including pterygium) are evaluated on "corrected distance vision" per 38 CFR 4.76(b)(1) http://www.benefits....ts....9.DOC . Based on the 2012 examination, your evaluation for the bilateral pterygia would be 10%. From 38 CFR 4.79 DC 6034-6066:

Vision in one eye 20/50 (6/15):

In the other eye 20/50 (6/15)....................................................................................... 10

In the other eye 20/40 (6/12)....................................................................................... 10

Based on your statement that a reduction from 40% to 20% is proposed, I suspect that you have another, separate 10% evaluation someplace somewhere ... is that correct?

WRT Since, the reduction is being reviewed does this mean that the CUE "they found" before is now reversed and their own findings were wrong when they said it was a CUE??? No, that's not it means. I suspect that the CUE from 2007 was based on the fact that your eye condition earlier might have been evaluated on the basis of only eye being service connected, which the CUE corrected.

So, the CUE stands ... but the evaluation might not stand because a particular evaluation or rating level does not become permanent until that evaluation has been held for 20 years or more.

The problem, as I see it, is that you have two separate examinations (2110 and 2012) which showed improvement from the examination associated with your 2007 claim. It mighta been neat to see the exam results from 2007 (to include the corrected visual acuities) and also see the visual acuities from the 2010 examination, but that's kinda moot at this point.

SC was for both eyes at time of discharge but only had treatment in service for one eye but was noted that both eyes were a problem ie blurry vision, redness and unable to read for long periods.

Due to the surgery on the right eye twice the scarring has caused "astigmatism" eye looks like the shape of a football when photos were taken. This eye is basically going to be gone due to the astigmatism and pterygium which cannot be removed at this point as it is on the cornea.

Eye exam in 2010 notes: Pterygium BE, s/p pterygium surgery with iron line deposit, corneal scarring & irregular astigmatism RE > LE, s/p PTK RE for stromal scar.

Further states in "Assessment"

1. refractive error/presbyopia

2. diabetes with no retinopathy BE

3. choroidal nevi LE

4. mild cataracts BE

5. pterygium BE, s/p surgical removal with persistent corneal scarring and irregular astigmatism, h/o inability to adapt to contact lens wear

Slit lamp & external eye exam cornea: marked other, describe: pterygium RE, surface irregularity LE. Lens: describe: ant cortical opacities BE

C&P exam 2012 under "Corneal conditions" Does the veteran have another corneal condition that may result in an irregular cornea? (Fore example, pellucid marginal degeneration, irregular astigmatism from corneal scar, post-laser refractive surgery, acne rosacea keratopathy, etc.) Dr. says "NO". Previous notes from 2010 exam states other wise.

Next page of questions in C&P under cataract condition: "Preoperative (cataract is present) which is marked for BE then, it says : Is the Veteran's decrease in visual acuity or other visual impairment, if present, attributable to any of the eye conditions checked above in this section he says no. If no, explain: decrease due to high astigmatism. (I understand this to mean Cataract condition does not cause astigmatism).

Next page under "Functional impact" ... impact his/her ability to work? Dr. marked "YES" If yes, describe impact: "HIs borderline vision would limit him for many occupations".

Remarks if any: Cataracts are likely due to diabetes which has a high prevalence of cataracts.

Visual acuity: 20/200 RE, 20/100 LE (UC distance), UC near 5/200 RE, 5/200 LE, CD 20/50 RE, 20/40 LE, CN 20/100 RE, 20/70 LE.

Since, the reduction is being reviewed does this mean that the CUE "they found" before is now reversed and their own findings were wrong when they said it was a CUE???

As for the "Boots on the Ground" ship is not listed as of yet. I have been put on the AO list, had the exam etc but nothing more. When I went to file for this lastest C&P exam VA rep told me that my claim for AO exposure was denied before and it was a "dead issue". I can remember being able to see soldiers on the shore firing at our ship so we had to have been pretty close.

Going for a IMO in two weeks.

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Posted

Ditto on what jvretiredvet has posted but will add you can put the reduction off

by request a hearing in writing and that no further action be taken on the proposal

to reduce prior to having the hearing (being provided with due process).

If you can obtain medical evidence by a provider with the correct pedigree,

that shows your vision to continue to fall into the criteria for the 40 percent

then that can keep the reduction from taking place.

JMHO

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